Tumor Necrosis Factor Inhibitors in the Management of Cancer-Associated Weight Loss Syndrome

The vast majority of patients with advanced cancer suffer from cancer-associated weight loss syndrome, which adversely affects prognosis and quality of life. This syndrome is characterized by loss of appetite, erosion of lean and adipose tissue and causes progressive weight loss, which is refractory to caloric supplementation. Tumor necrosis factor (TNF) plays a crucial role in the pathogenesis of this syndrome. Various strategies to inhibit TNF and thus reverse the cancer-associated weight loss syndrome are being explored. A randomized controlled study on the use of Pentoxifylline had not shown any benefit. Other inhibitors of TNF, namely Thalidomide and Melatonin, have shown some promising results. Currently, there is interest in testing novel inhibitors of TNF including infliximab and etanercept, which are approved for the treatment of Rheumatoid Arthritis and other inflammatory conditions. Ongoing clinical trials should define the role of these agents in the management of the cancer-associated weight loss syndrome.